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XII.-ON CRANIAL DEFORMITIES.-TRIGONOCEPHALUS. By W.
Turner, M. B. (London), F.R.S.E. Senior Demonstrator of Anatomy, University of Edinburgh. (Read before the British Associa
tion at Bath, September 16th, 1864.) In the number of this Journal for January, 1864, I communicated an article on cranial deformities, in which I discussed the influence exercised on their production by the premature closure of the cranial sutures. And I illustrated the effects of premature synostosis, by describing and figuring several examples of a peculiarly elongated and laterally compressed form of skull, termed Scaphocephalic, the characteristic shape of which was evidently due to a premature closure of the sagittal suture. On this occasion, I am desirous of directing attention to another very remarkable form of head, in which whilst the sides of the forehead are compressed, the middle line is projected forward in a beak-like manner, and which apparently owes its peculiar shape to a premature closure of the frontal suture.
The case I shall adduce in illustration of this kind of cranial deformity, the only one I have as yet met with, occurred in the person of a boy, between five and six years old, the son of Irish parents.*
When a full or three-quarter face view of the head of this child was taken, the peculiar form of the frontal region was very apparent;
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* For the opportunity of examining and obtaining photographs of this boy, I am indebted to my friends, Dr. Joseph Bell and Mr. David Young.
the lateral bulgings indicative of the position of the frontal eminences were altogether absent, and the forehead instead of being rounded off on each side to the temporal regions, was flattened, or even concave above the orbits and eyebrows, the hollowing out of the sides of the forehead, extending upwards as far even as the line of the hair. The middle line of the forehead on the other hand, presented a very different appearance, for it projected forwards forming a sort of beak, narrow below at the root of the nose, but gradually swelling out laterally and becoming more prominent as it approached the line of the hair, the bulging being necessarily more strongly brought out by the concavities on each side, above the eyebrows. Examined from the front, this beak-like bulging had a triangular form, its aper and most receding part being at the nose, its base at the line of the hair. On a profile view the forward projection of the middle of the forehead came out very decidedly, so that this part of the cranium somewhat overlapped the face. The appearance presented by the head when looked at from above, was very characteristic. Between
the parietal eminences, it possessed a breadth of 5.7 inches, which was the broadest part of the head ; traced backwards to the occiput, its transverse diameter slightly diminished, and the head had a rounded form posteriorly; traced forwards its transverse diameter diminished much more considerably, and at the middle line of the forehead, corresponding to the beak seen on a front or side view, it came almost to a point. The object it most resembled in form from
this aspect, was a broadly shaped egg, the narrow end of which was directed forwards; or it might be compared to a triangle with a rounded base.
The boy was a well grown healthy looking child, and exhibited an amount of intelligence, quite equal to that usually possessed by children of his age or condition of life. The mother told me that his head was noticed, immediately after birth, to possess a peculiar form, and she particularly states that he had no opening (anterior fontanelle) on the top of his head. In all other respects he was perfectly well formed. Her labour was natural. She has had four other children, but their heads were without any special peculiarity.
The following are a few of the principal measurements:-greatest length from the most projecting part of the beak, to the most prominent part of the occiput 7.2 inches.—Longitudinal arc to the occipital protuberance 125.- Intermeatoid arc 13.7.-Horizontal circumference round the most projecting part of the beak 20:5: round the root of the nose 19:5.–From these measurements, as well as from an inspection of the head, it is evident that the general capacity of the cranium is good, the space lost in the frontal region by its lateral compression being compensated for by increased growth in the parietal and occipital regions.
I have had no opportunity of anatomizing this or any other specimen of a similarly formed skull, so that I cannot speak from personal observation of the exact condition of the cranial bones and their sutural margins, but so far as one can judge from an external inspection of the living head, I have no doubt that this boy's skull corresponds closely with those crania which have been described and figured by Professor Welcker of Halle, by the name of Trigonocephali.* The skulls of this form, which Welcker has personally examined, are those of two new-born children, two children about five years old, and one adult male probably between 50 and 60 years of age; but he has in addition seen a plaster cast of the head of a newborn Trigonocephalus, in the Medico-Chirurgical academy at Dresden, and he refers to a case described by Von Ammon, and to a specimen described by Meissner in the Museum at Breslau, of apparently the same form, and these seem to be the only cases which have been recorded of this description of cranial deformity. In all of them, the peculiar beaked form of the middle of the frontal region, the absence of frontal eminences, and consequent hollowness of the sides
• Untersuchungen über die Menschlichen Schädeln. Leipzig, 1862. Zwei seltnere Difformitaten des menschlichen Schadels. Halle, 1863.
of the forehead above the eyebrows and orbits, the comparative breadth across the parietal region, so that the norma verticalis approached the triangular form, (the apex at the forehead, the rounded base at the occiput,) were well marked, and showed their close alliance to the boy's head I have just described. The two new-born children examined by Welcker, had both hare lips and cleft palates, but in none of the other cases did such malformations exist. In several of the cases also he noticed that the eyes, owing to the diminished breadth of the inter-orbital space, were more closely set together than is usual. In my case this peculiarity was but slightly marked.
Two theories may be advanced, to explain the production of this description of cranial malformation. 1st. That the frontal bone had only possessed a single ossific centre, situated in the middle line. 2nd. That it had in the usual manner two primary ossific centres, but that these, instead of remaining distinct and separated from each other, had very early become blended together, so as to form in the middle line the projecting beak, so characteristic of this form of cranium. Along with Welcker I am inclined to support the latter theory. For I believe, that, if the first named mode of development had occurred, a much greater amount of deformity would have been occasioned, than is exhibited by these crania, and that a Cyclopian or other monstrous form of head would have been produced. If the second of these two theories be accepted, then these Trigonocephali are, as regards the principle which regulates their mode of production, closely allied to those Scaphocephali already alluded to, in which, as has been contended by Virchow, Welcker, and myself, the lateral compression of the cranium in the parietal region, is due to a premature blending of the ossific centres of the two parietal bones, and a consequent obliteration of the sagittal suture. The head of the boy whose case I have detailed, supports the view that this premature blending of the two originally distinct halves of the frontal bone, took place at a period of fætal life, some time before the termination of intra-uterine existence, for if the statement of the mother is to be trusted, there was a complete absence of the fontanelle at the time of birth. It does not necessarily follow, however, that this intra-uterine closure of the anterior fontanelle is a constant occurrence in these cases, for in the heads of the two new born children, figured by Welcker, the anterior fontanelle is open, and in the head of one of the 5-year old children, a distinct anterior fontanelle bone existed.
XIII. – PROCEEDINGS OF THE SCIENTIFIC SOCIETIES OF LONDON.
1. ETHNOLOGICAL SOCIETY. (4, St. Martin's Place.)
November 8th, 1864. SOME skulls exhumed in 1863 in the province of Spiti, a part of Ladak, or Chinese Thibet, were presented to the Society by Mr. Philip Egerton, of the Bengal Civil Service. These skulls were interesting as coming from a region where the Caucasian and Mongolian families meet.—Mr. S. J. Mackie exhibited a fine series of eighteen fint implements from a gravel drift of Bedford, collected by J. Wyatt. -A note from Count Marschall was read, giving an account of the researches of Prof. Jeitteles in the peat-bogs of Olmütz, where human bones and works of primitive art had been found in association with remains of ox, boar, and horse.—Mr. T. Wright, Hon. Secretary, gave an account of the proceedings in the Ethnological Section of the British Association at Bath, which were deemed highly satisfactory. -An account by Dr. Shortt, was read, “ of some rude Tribes, supposed Aborigines, of Southern India." These tribes were the Yenadies of Ireehuree Cottah, a flat, sandy island on the Coromandel coast, the Villees met with in the outskirts of every village of the district; the Iroolers residing for the most part around the village of Nagalapooram, at the foot of the Ramagherry Hills; and the Dombers. The Yenadies were described as having Mongolian features, and speaking a slightly corrupted dialect of Teloogoo; the Villees, too, have the Mongolian type strongly marked; the Iroolers are seemingly of the same caste. “Dommari” and “Dombari" are applied to a certain low caste of natives, supposed to be one of the great aboriginal races, whose chief occupation at the present time is the performance of acrobatic feats. They are tall, tolerably well made, with complexions varying from bamboo to copper colour, and in some merging into black. The predominant type of countenance is stated as Mongolian.- A second paper was read, “On the Fixity of Type,” by the Rev. H. Farrar, in which the author contended that an extraordinary fixity of type had characterized the races and varieties of mankind since the earliest dawn of history, and quoted numerous examples, including the Egyptians, Jews, Negroes, and Assyrians, to prove his point.--Mr. Phillips exhibited a series of